Keto can be part of a chronic or allergy induced asthma patients’ changing lifestyle habits to better cope with asthma
Although chronic asthma is not necessarily a condition with a high-mortality rate, it does incur high health care costs, both directly and indirectly. According to the American Lung Association, annual direct health care costs for asthma or allergy induced asthma care are approximately $50 billion.1
Indirect costs add another approximate $6 billion, making a grand total of approximately $56 billion per year. If we look specifically at worker productivity, more than 10 million work days were lost in 2013 as a direct result of employees dealing with symptoms of asthma.1
Given these statistics, it is clear that you need to keep a careful watch on your patients who have chronic or allergy induced asthma. Part of this task may include helping them change their lifestyle habits to better cope with their asthma. Recent research may offer some insight into how changing to a keto diet may help reduce inflammation of the respiratory system.
How the keto diet works
The ketogenic, or keto diet, is an extremely low carb diet in which carbs are reduced to less than 10% of the total daily food intake, replaced mainly by lean meats and fresh fruits and vegetables.2 When the glucose normally found in carbs is eliminated, the body must find another source of fuel, so it will instead begin burning fat.
The liver converts this fat into ketones, which become the body’s alternate food source. Because the body requires so much of an increase in fat to serve as this fuel, the keto diet increases fat intake to anywhere from 70% to 90% of total consumption for a 2,000 calorie per day diet.2,3
Asthma and the inflammatory response
Acute inflammation of the respiratory tract in response to an irritant, such as an allergen, is actually an important part of the body’s natural immune system. As part of this response, a special group of cells, called innate lymphoid cells, helps increase mucus production to expel harmful substances or pathogens from the bronchial tubes.
For otherwise healthy subjects, mucus production then decreases, once the threat has been eliminated. In the case of those with asthma, however, the innate lymphoid cells do not turn off mucus production, so the inflammatory process becomes chronic. This can then lead to inflamed bronchial tubes and breathing difficulties normally associated with chronic asthma.
Allergy induced asthma and slowing inflammation
A recent study in the journal Immunity used mice examined the effect of a Ketogenic diet on inflammation of the respiratory tract, following exposure to an allergen.4
Because the innate lymphoid cells rapidly multiply, the researchers’ goal was to slow down their division, which should also slow the chronic inflammatory process. They found that fatty acids were required to help form the innate lymphoid cells, so fed mice bred to be asthmatic a keto diet and then exposed them to an allergen.
Because the mice were on this diet, fatty acids were diverted away from building innate lymphoid cells to instead be converted into ketones. With fewer innate lymphoid cells available, the inflammatory process in the lungs dramatically slowed down.4
Given concerns over COVID, it is only natural for your patients with chronic asthma to be concerned. They may find that a keto diet can not only help them lose weight, but might also reduce some of the respiratory symptoms associated with chronic asthma attacks.
References
- Asthma in Adults Fact Sheet. American Lung Association. Updated Feb.27, 2019. Accessed Aug. 25, 2020.
- Masood W, Uppaluri KR. Ketogenic diet. [Updated June 20, 2020]. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing.
- Shilpa J, Mohan V. Ketogenic diets: Boon or bane? Indian Journal of Medical Research. 2018;148(3):251-253.
- Karagiannis F, Masouleh SK, Wunderling K, et al. Lipid-droplet formation drives pathogenic group 2 innate lymphoid cells in airway inflammation [published correction appears in Immunity. 2020 May 19;52(5):885]. Immunity. 2020;52(4):620-634.e6.
